Patellar Tendonitis Treatment in Singapore

Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)

What is Patellar Tendonitis?

Patellar tendonitis, also known as jumper’s knee, is an injury to the tendon that connects your kneecap to your shin bones. This is the same tendon that allows you to straighten your knees. This condition is characterised by inflammation of the patellar tendon, which results in pain and tenderness at the front of the knees. Swelling may be present in the area, and the pain may be especially severe when kneeling, bending or straightening your knee. Jumping, running and walking will also be affected. If left untreated, tears may occur in your tendon.

Symptom of Patellar Tendonitis

There are a few symptoms of patellar tendonitis. The most common are:

  1. Pain and tenderness below your kneecap 
  2. Swelling around your kneecap
  3. Pain when bending or straightening your leg
  4. Tenderness behind the lower part of your kneecap

Diagnosing Patellar Tendonitis

Patellar tendonitis can be mistaken for other injuries including quadriceps injury, knee bursitis, meniscal injuries as well as other pathologies of the knee. An orthopaedic specialist will usually diagnose this condition based on your symptoms and a physical examination. An X-ray, ultrasound or other medical imaging technology may be needed to clarify the severity of your condition.

Additionally, the attending physician will analyse your symptoms around the kneecap to account for tenderness, pain, swelling, bruising or discomfort. They will also assess which stage of patellar tendonitis you might be at, considering your activities and symptoms:

Stage 1

During this stage, you may still be able to go about your daily activities without any functional impairments, with pain only occurring after the activity.

Stage 2

In the second stage, pain may be experienced both during and after activities, although it is possible for an individual to perform activities as normal.

Stage 3

In the third stage, pain is experienced during activities and persists long after. Athletic performance is progressively impaired and can only be achieved by “powering through the pain”.

Stage 4

In the fourth stage, the patellar tendon will have deteriorated to such an extent that surgical repair may be the only way to recover from the injury.

Non-surgical Patellar Tendonitis Treatment

In order to manage patellar tendonitis, physiotherapy may be prescribed to aid with the flexibility of muscles surrounding the knee, like the quadriceps and hamstring. Some physicians may also prescribe anti-inflammatory injections or analgesic medication to address the pain. Other therapy options for patellar tendonitis include dry needling, hypothermia thermotherapy and extracorporeal shockwave therapy. 

The type of therapy administered will depend on the individual's specific condition, including the severity of their symptoms and how they respond to initial therapies.

What Happens During Patellar Tendonitis Surgery

Most cases of patellar tendonitis can be managed with non-operative support. This means that invasive options like knee surgery are often recommended as a last resort for severe tendon tears once more conservative and non-invasive options have been exhausted.

If advised, an arthroscopic debridement surgery may be carried out. This surgery involves inserting a small camera and surgical instruments into the knee joint to help the surgeon remove damaged tissue. If your patellar tendon needs to be realigned, your doctor may opt for an arthroscopic resection of the inferior aspect of the patella.

Recovery Period For Patellar Tendonitis Surgery

As with all conditions, the time taken for full recovery will depend on the individual’s condition. Most people with mild to moderate patellar tendonitis should experience some level of improvement in their condition within the first few months with diligent rest and strengthening exercises.

Additionally, it is recommended to continue with physical therapy even after your initial injury has healed to help reduce the risk of recurrent injury or your condition turning chronic.

Dr Gowreeson Thevendran

MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed ( Trauma & Ortho. ), FAMS (Singapore)

Dr Gowreeson Thevendran is an orthopaedic surgeon who specialises in lower limb orthopaedic conditions, trauma, and fracture surgeries of both the upper and lower limbs. He received his medical education from the University of Bristol and completed his surgical training in the UK and Canada. Before establishing his private practice, he served as Chief of Foot & Ankle Surgery, Department of Orthopaedics at Tan Tock Seng Hospital, Singapore.

Dr Gowreeson Thevendran’s Qualifications and Awards:

  • Bachelor of Medicine and Surgery, University of Bristol, England
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Diplomate Faculty of Sports and Exercise Medicine, Royal College of Surgeons Edinburgh
  • Fellow of the Academy of Medicine, Singapore
  • SICOT PIONEER Founders Award 2020
  • 2015 European Foot & Ankle Society ‘Best Podium Presentation’ Award
  • 2013 Singapore Orthopaedic Association Junior Travelling Fellowship
  • 2012 NHG Critical Talent Special Recognition Award
  • 1998 Enid Lindt Prize in Clinical Surgery
  • 1995 Public Services Department Full Medical Scholarship

Frequently Asked Questions About Patellar Tendonitis

1Can I continue participating in competitive sports if I have patellar tendonitis?

While it might be tempting to power through the pain and participate in athletic competitions as per usual, this is not advisable as you’ll run the risk of causing your condition to worsen.

Therefore, athletic participation should be minimised and only engaged in after consulting with a trained physician. Your physician will be able to come up with a management plan taking into account your athletic goals and the health of your body. Additionally, daily exercises should be modified to include adequate warm-ups and rest periods, with priority given to knee strengthening exercises.

2What are the causes of patellar tendonitis?

Patellar tendonitis is often caused by the overuse or injury of the knee joint. It is commonly experienced by:

  1. Individuals who frequently engage in activities that result in high impact on the knee area, such as frequent squatting or jumping on hard surfaces.
  2. The elderly whose tendons are less elastic and more prone to injury.
  3. Individuals with structural abnormalities in the lower limbs, like flat feet or weak gluteal muscles. 

Additionally, patellar tendonitis can occur from a sudden increase in activity, poor training techniques, improper footwear, and insufficient warm-up and stretching exercises. If the individual continues to power through with strenuous activity despite the pain, microscopic fractures on the lower edge of the kneecap can occur. The soreness will likely develop into a chronic condition.

3What happens if patellar tendonitis is left untreated?
If patellar tendonitis is left untreated, it can lead to worsening pain and discomfort, potentially restricting daily activities and athletic performance. Over time, the tendon may weaken, increasing the risk of tears or ruptures that require more extensive support. Chronic inflammation can also cause the tendon to degenerate, leading to long-term knee problems and decreased joint function.
4What are the risks or complications of patellar tendonitis surgery?
The risks or complications associated with patellar tendonitis surgery may include infection, bleeding, and nerve damage, which are common to many surgical procedures. There's also a specific risk of weakening or rupture of the patellar tendon itself. Post-surgery, patients might experience stiffness, decreased range of motion, or difficulty in fully recovering strength and flexibility. Additionally, as with any surgery, there's a possibility that the operation does not fully resolve the pain or functional issues.
5Does insurance and MediSave cover patellar tendonitis treatment?
Depending on the extent of your injury and the type of procedure, certain therapies for patellar tendonitis may be claimable under your insurance provider or MediSave. Therefore, patients are recommended to visit the clinic and confirm the eligibility of their treatment for MediSave claims and the level of coverage offered by their insurance provider.
6Who usually needs patellar tendonitis treatment?
Patellar tendonitis is a common condition that can impact individuals of all ages. Although, it is more prevalent in those who are involved in sports or activities that put stress on the knees such as athletes who participate in basketball, volleyball, or gymnastics. Likewise, people who have flat feet, high arches, or other structural abnormalities of the feet or legs may also be more prone to developing this condition. Those who experience pain, swelling, and stiffness in the knee joint should seek medical attention from an orthopaedic surgeon, who can diagnose the condition and recommend appropriate procedures based on the severity of the injury.

Clinic Location

OrthofootMD@Novena

OrthofootMD@Mount Alvernia Hospital

Dr Gowreeson Thevendran is currently an orthopaedic surgeon with Island Orthopaedic, a one-stop care centre for orthopaedic health under Healthway Medical Group. He specialises in treating lower limb orthopaedic conditions, as well as trauma and fracture surgery of both the upper and lower limbs. Prior to establishing his private practice, Dr Gowreeson was Chief of Foot & Ankle Surgery at the Department of Orthopaedics at Tan Tock Seng Hospital (TTSH). Today, he continues to serve the Orthopaedic Department at TTSH as a visiting consultant.

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